Provider Demographics
NPI:1336504828
Name:MAGALIS AGUILERA, PSY.D., P.A
Entity Type:Organization
Organization Name:MAGALIS AGUILERA, PSY.D., P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAGALIS
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUILERA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:305-595-8787
Mailing Address - Street 1:9240 SW 72ND ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3261
Mailing Address - Country:US
Mailing Address - Phone:305-595-8787
Mailing Address - Fax:305-595-6087
Practice Address - Street 1:9240 SW 72ND ST
Practice Address - Street 2:SUITE 106
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3261
Practice Address - Country:US
Practice Address - Phone:305-595-8787
Practice Address - Fax:305-595-6087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-28
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6494261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL510095713OtherUNITED HEALTH CARE OPTUM CARE
FL54830OtherFLORIDA BLUE
KY0007718517OtherAETNA